École des sciences de la réadaptation, Université Laval, Quebec City, Canada.
École de réadaptation, Université de Montréal, Montreal, Canada; Institut de Cardiologie de Montréal, Montreal, Canada.
Braz J Phys Ther. 2023 Nov-Dec;27(6):100560. doi: 10.1016/j.bjpt.2023.100560. Epub 2023 Nov 7.
In Canada, as in other countries, the physical therapist (PT) must make a diagnosis to comply with direct access responsibilities. This means making a diagnosis is an entry-to-practice essential competency. However, there is no consensus across physical therapy practice domains and contexts regarding the diagnostic concept, i.e., the classification system, labelling and diagnostic format that should be used.
To propose a universal diagnostic concept, one a PT could use regardless of their practice domain or context.
The relevant scientific and grey literature (1986-2022) were searched and key information was synthesized.
Information from 194 retained documents (8506 identified) was synthesized to a list of seven essential criteria that were then used to develop a universal physical therapy diagnostic concept (PT-Dx-C). The PT-Dx-C format consists of three labels in the following order: (1) health problem, (2) primary impairment, and (3) primary activity limitation or participation restriction. Label definitions are those used by the World Health Organization. The specific health problem, impairment, and limitation or restriction making up the diagnosis are determined for each patient using valid tests and measures.
The PT-Dx-C is consistent with best practices and could be applied to all patients, in all PT practice domains and contexts. It reflects the PT's expertise in the human movement system and their unique contribution to health care. Furthermore, its use may allow for communication of the PT's conclusions in a manner that can be understood by others thereby facilitating collaborative practice.
在加拿大,与其他国家一样,物理治疗师(PT)必须进行诊断才能履行直接访问的责任。这意味着诊断是一项进入实践的基本能力。然而,在物理治疗实践领域和背景下,对于诊断概念,即应该使用的分类系统、标签和诊断格式,没有达成共识。
提出一个普遍适用的诊断概念,即无论 PT 的实践领域或背景如何,都可以使用的概念。
搜索了相关的科学和灰色文献(1986-2022 年),并综合了关键信息。
从 194 篇保留文献(8506 篇确定的文献)中综合出 7 项基本标准,然后用于制定一个普遍适用的物理治疗诊断概念(PT-Dx-C)。PT-Dx-C 格式按以下顺序包括三个标签:(1)健康问题,(2)主要障碍,(3)主要活动受限或参与受限。标签定义采用世界卫生组织的定义。使用有效的测试和措施为每个患者确定构成诊断的具体健康问题、障碍和限制或受限。
PT-Dx-C 符合最佳实践,可以应用于所有患者,在所有 PT 实践领域和背景下。它反映了 PT 在人类运动系统方面的专业知识及其对医疗保健的独特贡献。此外,它的使用可以使 PT 的结论以其他人可以理解的方式进行沟通,从而促进协作实践。